Secondary infertility

You've had your first baby, you're feeling as if the parenthood lark is all going quite well, so you decide to go for baby number two. But despite no problems conceiving first time round, it just doesn't seem to be happening for you this time. You may be suffering from secondary infertility.

What is secondary infertility?

Secondary infertility is defined as the inability to conceive after having already had one or more children naturally and it's thought to affect as many as one in five couples.

It can be an incredibly frustrating thing to experience - and it is often met with little sympathy you already have a child.

What are the causes of secondary infertility and when should you seek help?

Secondary infertility is more common than primary infertility and it has a multitude of causes:

Delayed motherhood - as women leave it later to have their first child, their fertility is naturally declining when they begin to try for another. On top of this are the strains that parenthood has on the body, mainly tiredness. You may also be more prone to diabetes and excess weight as you get older, which both have an impact on fertility.

Fertility expert Zita West has suggested that the thyroid gland may not work as well after a first birth and so hormones can become unbalanced

Pregnancy can affect insulin resistance, which in turn affects hormone production and can cause infertility.

Having a caesarean has been shown to add to the difficulty of conceiving a second time as it may cause adhesions and blockages in your reproductive organs.

You may also have a pre-existing problem that has worsened since you had your first baby, such as:

Polycystic ovary syndrome

Endometriosis

Fibroids

Damage to fallopian tubes caused by an ectopic pregnancy

Damage caused by a sexually transmitted infection

If you have tried to conceive for a year or more, you should go and see your GP and try to get some expert advice from fertility experts.

If you're over 35, you might want to go earlier, maybe after six months, because your fertility will be declining and you want to give your body the best chance of conceiving.

Your doctor can test to see if you are ovulating and will also check your partner to see if there are any problems with the quality of his sperm.

After trying to find out what is causing your infertility, a fertility specialist can advise on a possible cause of action. Sometimes, frustratingly, it isn't possible to find a cause and some people will not go on to have another child. But about 60% of couples with unexplained fertility do go on to have a child, so the odds are stacked in your favour.

What Mumsnetters say about secondary infertility

I have got a wonderful daughter aged two and a half and have been trying for another one for 16 months now. My partner and I have had all the tests - the diagnosis was unexplained infertility. We're having IUI now, but without success so far. All my friends have either had their second children or are pregnant again. I want to feel happy for them but I just feel sad and isolated - and angry with myself for not having started trying to conceive earlier. Duplomania

It's so heartbreaking when everyone around you is popping children out left, right and centre (or so it feels). Wheelybug

Just because we drift towards the infertile label, doesn't mean that at some point we won't drift back to the fertile label in future. There are so many couples who go through infertility and then suddenly, unexpectedly find they are pregnant. piprabbit

It is laughable the rubbish people not trying to conceive say: Just relax. It will happen when it happens. You've got one, so it shows you can do it. When are you going to have another? How old is your baby now? Are you thinking of another yet? maximum123

Secondary subfertility is more common than people realise and subfertility is not the sole preserve of the woman. See if you can get any help under the NHS initially. If you decide to go private, do your research thoroughly beforehand and ask lots of questions. Some private clinics offer poor as well as expensive treatment. Both of you need further testing and tests should be done in tandem. It is no point at all solely testing you without your partner being tested. AttilaTheMeerkat

My daughter took three months and there was no stress/counting days involved. I did think it was lucky but when that's happened for you, you can't help but expect it to happen like that again. Started TTC when she turned one. We had 15 months of trying and hoping and - nothing. Everything became horrible and stressful, counting days, trying, waiting, being disappointed. Got to the point I was feeling quite obsessive about the whole thing. Then the test was positive. I am still feeling really, really grateful. Don't know the reason it took so long (I'm now 35). I think you have to try to believe you'll get there, if you hang in there. Is tough though. beatofthedrum